Download Adult Hemiplegia Evaluation and Treatment: Evaluation and by Berta Bobath PDF

By Berta Bobath

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If resistance is slight, the patient is able to perform the movement in a fairly normal manner, but with greater effort and at a slower rate than is normal. Such abnormal resistance due to spasticity is encountered in the arm, hand and fingers with all movements of extension, external rotation, supination and abduction of fingers and thumb, and also with elevation and horizontal abduction of the extended arm and hand and with full adduction of the arm with flexed elbow and extended wrist and fingers, as in touching the opposite shoulder.

Gradually, with the patient's progress under treatment, those of grades 2 and 3 may be added. Tests of balance and other automatic reactions can only be attempted in the moderate or slight cases and have not, therefore, been graded. I. TESTS FOR THE QUALITY OF MOVEMENT PATTERNS The patient who can move his limbs actively, that is, the patient with moderate spasticity, can only use total flexor and/ or extensor synergies. He lacks selective movements. Flexor muscles may contract in total patterns of flexion of the whole limb against the resistance of extensor spasticity, and extensor muscles act only in total patterns of extension EVALUATION OF MOTOR PATTERNS FOR ASSESSMENT 35 against the resistance of flexor spasticity.

With pronation? With supination? With adducted fingers and thumb? With abducted fingers and thumb? Grade 3 a. Can he grasp and open his fingers again? With flexed elbow? With extended elbow? With pronation? With supination? b. Can he move individual fingers? Thumb? Index finger? Little finger? 2nd and 3rd finger? c. Can he oppose fingers and thumb? Thumb and index finger? Thumb and 2nd finger? Thumb and little finger? Yes? No? 40 ADULT HEMIPLEGIA: EVALUATION AND TREATMENT Test for Pelvis; Leg and Foot'--<:ontd.

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